Interv Akut Kardiol. 2006;5(1):19-22

CATHETER-BASED THERAPY FOR IN-STENT RESTENOSIS

Tereza Pučelíková, Jiří Kettner

Klinika kardiologie, Institut klinické a experimentální medicíny, Praha

Stent implantation during percutaneous coronary intervention has dramatically improved the clinical outcomes of patients with coronary artery disease. The main limitations of this method remain the development of in-stent restenosis (ISR) in some patients and the high recurrence rates after reintervention. It is not surprising that mechanical strategies have not improved long-term outcomes of patients treated for ISR since they do not address the main cause of ISR, ie, neointimal hyperplasia. Only two methods, suppressing neointima formation, have been proved to reduce the recurrence rates after catheterization treatment – intracoronary brachytherapy and drug-eluting stent (DES) implantation. Head-to-head comparison favoured DES implantation in this clinical setting. DES implantation is the treatment of choice for bare metal stent ISR and should be performed in all patients if technically possible and if stent underexpansion is excluded. The main limitation is the high cost of this treatment.

Keywords: coronary angiography, percutaneous transluminal coronary angioplasty, stents, coronary restenosi

Published: January 1, 2006  Show citation